For a cervical cancer patient who had involved para-aortic lymph nodes, how much higher do you extend the superior edge of your field if there are nodes close to the renal vessels (i.e. usual superior extend of field)?

In this dataset from us, next station was retrocrural nodes with involvement more than 25% and for that reason, we extend CTV for 2-3 cm above renal vessel to include retrocrural nodal region and space.

Kabolizadeh et al., PMID 23849691

In cervical cancer, the most frequent para-aortic metastasis is the below renal vessels, usually L1/L2 interspace. However, if there are positive nodes close to the renal vessels, I would extend para-aortic fields, 1 or 2 vertebral body cranial to the highest positive nodal which makes better anatom...

Generally, for these situations, I would go to the level of the diaphragm and include the retrocrural nodes.